Gov. Paul LePage has decided to let the federal government establish a health insurance exchange in Maine. Today was the original deadline for states to make a decision on whether they would establish their own exchanges as part of the Affordable Care Act. That deadline has been extended, but LePage says the Affordable Care Act is a stepping stone to a single-payer system and that Maine will "not be complicit in the degradation of our nation's premier health care system." Patty Wight has the details.

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Maine Gov Turns Health Exchange Set up Over to Fed

Duration:3:26

Gov. LePage sent a letter to U.S. Health and Human Services Secretary Kathleen Sebelius yesterday informing her of the decision. His letter came just a day after the Republican Governor's Association sent a letter to President Obama asking for a meeting to discuss the lack of guidance they've received on health insurance exchanges - future organizations where consumers and small businesses can go to compare and buy health insurance starting next fall.

"I think what you have here is a federal government that has had more than two-and-a-half years to put the guidance in place for states, and we still don't have that," says Gov. LePage's spokersperson Adrienne Bennett. "So that's why you see so many governors not taking action with a state-based exchange at this point."

So far, 17 states have decided to set up their own exchanges. Bennett says LePage and other governors have many unanswered questions, but the overarching one is: How will states pay for the exchanges? "We know that those costs are going to be passed on to the consumers who use the exchange."

Former Republican lawmaker Joe Bruno was the chair of the Health Insurance Exchange Advisory Commission - a nine-member group appointed by Gov. LePage in 2011 to make a recommendation on whether the state or the federal government should set up an exchange. "We had health insurers, we had consumers, we had hospital administrators," Bruno says.

Bruno says the group looked at the cost, and found that if Maine ran the exchange, it would probably cost between $2 million to $5 million a year. What if the federal government ran the exchange?

"We think it was going to be in the same ballpark, maybe even a little bit more, with those costs just passed on to the consumers of Maine," Bruno says.

Ultimately, the commission gave a unanimous recommendation: Maine should establish and run its own exchange. The reason, Bruno says, is local control. He says a federally-run exchange has the potential to be a one-size-fits-all model, not tailored to Maine's specific needs.

Democratic Rep. Sharon Treat, who serves on the Legislature's Insurance and Finance Committee, agrees. But she says it's too late for that. "At this point I don't think a state-run exchange would be better, to be honest," Treat says. "Because we have a governor that has made it clear that he wants it to fail."

Treat says she's confident that the federal government will establish a good exchange here, but she hopes in a couple years the state will take over. Treat says she's heard similar sentiments from legislators in both parties.

"I think there's a path for us, and for anyone who wants to work toward that path, I think for me, the door is open," she says. "Unfortunately, the governor has made it clear he's not interested in that path, or any path that relates to the Affordable Care Act."

But Gov. LePage's spokesperson, Adrienne Bennett, says the federal government isn't giving Maine the information and flexibility it needs. "And that's tying our hands," she says. "And we really need to find a way that we can have a quality safety net, and that we can afford it."

Joe Bruno, from the Advisory Commission, says he too wanted more details from the federal government when assessing how to implement the exchange. But he still thinks a state-run program is best for Maine. Bruno is the current chair of Dirigo Health - a state-run insurance program.

"We have done a lot of very similar work to an exchange, that it wouldn't take a whole lot to continue down that path to build a health insurance exchange," he says.